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Editor’s memo
Beyond Physical Well-Being
Psychosocial matters
often take a backseat to
some of the more easily
measured outcomes in
patients with pulmonary hypertension, particularly in the setting of clinical trials.
However, when dealing directly with patients and their families, these are often at
the top of their list of concerns. Unfortunately, for physicians and allied health
care professionals, psychosocial consequences of physical diseases are not necessarily a focus of previous educational
curriculums. Thus, while we know that
pulmonary hypertension places a physical
burden on patients, the psychosocial impact of the disease is less often addressed because practitioners may be
less comfortable, and frankly less
knowledgeable in these areas. But PH
patients living with a chronic disease
and associated physical limitations that
affect day-to-day activities are undoubtedly in need of guidance on how to
best care for their bodies and minds. As
we move into an era of more medical
treatment options and improving outcomes, these issues have emerged as
critically important. In fact, when it
comes to depression, exercise regimens,
and socio-emotional support, the issues
are often deeply intertwined with the PH
patient’s physical well-being.
In this issue of Advances, with Dr. Hap
Farber as guest editor, authors tackle issues around depression, exercise, and disability. By addressing the psychosocial
well-being of our patients, highlighted in
these articles and referring to specialists
when necessary, we can certainly provide
better and more comprehensive care to our
patients.
have an effect on the clinical status of our
patients and their outcomes.
To try to understand these aspects of
the disease to a greater degree, we explore
several of these “non-medical” issues that
have particular import to the patient: 1) attempts to define the toll that the diagnosis
itself has on the patient; 2) the effect of
the disease on the mental status of the
patient; 3) the effect of disability and selfworth on the patient; and 4) the role of
exercise in this disease. We also have a
fascinating roundtable for this issue— one
in which two very articulate and candid
patients discuss with us the real effects
that pulmonary hypertension has had on
various aspects of their lives. This roundtable is in many ways eye-opening and
covers issues that neither we, nor our patients, usually discuss during office visits.
We hope that this issue will begin
thought, discussion, and eventually solutions to the myriad of problems, in addition to the obvious medical ones, that our
patients face every day. I would consider
it a great success if it provokes such a
response.
Erika Berman Rosenzweig, MD
Director, Pulmonary Hypertension Center
Columbia University, College of
Physicians and Surgeons
Guest editor’s memo
It is again an honor and
privilege to serve as the
guest editor of an issue
of Advances in Pulmonary Hypertension; this
time, “Psychosocial Issues in Pulmonary Hypertension.”
Why, might you wonder, are we devoting an issue to this topic? Very simply, it
has not been done previously and these
are issues that we probably (definitely) do
not consider sufficiently. Our patients
have clearly benefitted from the medications we now have available; yet there are
other aspects of the disease, such as the
impact on daily life and family, that also
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Advances in Pulmonary Hypertension
Hap Farber, MD
Director, Pulmonary Hypertension
Center
Boston University School of Medicine